Integrated spot monitoring device with fluid sensor

ABSTRACT

An integrated lancing test strip device includes a lancet configured to form an incision in tissue and a test strip coupled to the lancet for analyzing body fluid. A retention mechanism acts as a detent to hold the lancet in a static position relative to the test strip before forming the incision. The retention mechanism is configured to release the lancet for retracting the lancet relative to the test strip to reduce smearing of body fluid by the lancet during collection of the fluid with the test strip. In one form, the retention mechanism includes breakable tabs that are broken to release the lancet, and the lancet is retracted via translational movement. The retention mechanism in another form includes one or more dimples that release the lancet when the lancet is retracted via rotational motion. In a further form, the entire integrated device is rotated to collect fluid.

BACKGROUND

The present invention generally relates to bodily fluid sampling devicesand more specifically, but not exclusively, concerns an integratedlancing test strip with a unique retractable lancet.

The acquisition and testing of bodily fluids is useful for manypurposes, and continues to grow in importance for use in medicaldiagnosis and treatment, such as for diabetes, and in other diverseapplications. In the medical field, it is desirable for lay operators toperform tests routinely, quickly and reproducibly outside of alaboratory setting, with rapid results and a readout of the resultingtest information. Testing can be performed on various bodily fluids, andfor certain applications, is particularly related to the testing ofblood and/or interstitial fluid. Such fluids can be tested for a varietyof characteristics of the fluid, or analytes contained in the fluid, inorder to identify a medical condition, determine therapeutic responses,assess the progress of treatment, and the like.

The testing of bodily fluids basically involves the steps of obtainingthe fluid sample, transferring the sample to a test device, conducting atest on the fluid sample, and displaying the results. These steps aregenerally performed by a plurality of separate instruments or devices.Performing these steps can be difficult for patients, especially forpatients with limited hand dexterity, such as the elderly, or thosesuffering the effects of their condition, like diabetes. Diabeticssuffer many symptoms that can make self-monitoring difficult. Forexample, diabetics can sometimes experience numbness or tingling intheir extremities, such as their hands, and also, wounds tend to healmore slowly for diabetics. In a typical procedure, the patient firstcreates an incision in the skin by lancing the skin with a lancet. Inorder to ensure that a sufficient number of capillaries are cut forsupplying an adequate bodily fluid sample, the incision has to usuallybe deep, which can be rather painful for the patient. Often, theincision still does not provide an adequate amount bodily fluid for thesample, and the patient then must resort to expressing the fluid fromthe incision. If during expression of the fluid the patient is notcareful, smearing of the fluid may occur, which may result in renderingthe sample useless. Once a sufficient amount of fluid collects as adroplet on the skin, the patient has to position a test strip over thesite such that the test strip contacts and absorbs a sufficient amountof the droplet for testing. Usually the droplet of fluid is quite small,and patients, especially ones with hand motor control problems, mayexperience great difficulty in positioning the test strip so as tocollect a sample from the droplet. As should be appreciated, patientscan become frustrated by this procedure, and consequently, they mayperform the test less often or may even quit testing altogether.

Recently, integrated lancing test strips have been developed in which atest strip is integrated with a lancet so as to form a single disposableunit. While these integrated units have somewhat simplified thecollection and testing of fluid samples, there are still a number ofissues that need to be resolved before a commercial unit can beimplemented. One issue concerns the interaction between the lancet andthe test strip during fluid collection. In one type of design, thelancet is fixed relative to the test strip and extends past the edge ofthe test strip. During lancing, the entire integrated lancing test stripis fired by a lancing mechanism to form an incision, and after formingthe incision, the entire integrated lancing test strip is typicallyretracted from the skin so that the blade is removed from the incisionin order to promote blood flow as well as to dull the pain.

With the lancet fixed relative to the strip, a number of difficulties insampling the fluid are created. For instance, as noted before, thelancet typically extends from the test strip near the capillary openingfor the test strip. At such a position, the blade of the lancet caninterfere with the collection of body fluid by smearing the droplet ofblood on the skin and/or by drawing blood away from the capillarychannel. Further, the distance that the capillary has to be retracted isdirectly proportional to the length of the lancet blade that extendsfrom the test strip. The greater penetration depth created by longerlancet blades usually increases the amount of blood that is bled fromthe incision, but the greater length of the lancet necessitates that thetest strip be retracted farther away from the skin, which in turn canreduce the chances that the blood will be successfully drawn into thecapillary channel of the test strip. Conversely, shorter lancets reducethe distance of the test strip from the skin, but shorter lancetsnormally produce smaller fluid sample sizes from the incision. Moreover,retraction of the entire integrated device is sometimes inconsistent,thereby leading to some undesirable consequences. If the integrateddevice is retracted too far from the skin, the capillary channel mightnot be able to contact the fluid droplet on the skin, thereby resultingan incomplete test or insufficient sample size for testing.

Some previous integrated disposable designs were proposed in which alancet is fixed to a body that holds a separate sensor, which is thenrotated into position to collect body fluid. However, the body for suchtype of disposable was typically made from an extruded plastic that madethem rather bulky and expensive to manufacture. Due to their bulkynature, these types of disposables were difficult to incorporate intomagazines, drums, cassettes, cartridges and the like.

To alleviate some of these difficulties, integrated lancing test stripshave been developed in which the lancet is moveable relative to the teststrip. However, such designs still have a number of drawbacks. One issueconcerns maintaining the sterility of the lancet so as to minimize therisk of infection. In practice, conventional plastic or syringe typecaps that are used to maintain the sterility of typical lancets cannotbe incorporated with the moveable lancet design for several reasons.With typical syringe type caps, the cap encapsulates the lancet, and thecap is removed by pulling or twisting the cap off the lancet. However,by its moveable nature, the removal of the cap from the lancet withoutdestroying the integrated device is difficult or even practicallyimpossible. For instance, as the cap is pulled, the lancet moves, whichin turn prevents the removal of the cap, and if pulled too much, thelancet can become dislodged from the rest of the integrated lancing teststrip. Another issue with the moveable lancet design concerns thepositioning of the capillary opening in the test strip after lancing.During a normal sampling procedure, the end of the test strip contactsthe skin during lancing so as to control the penetration depth of thelancet and remains in contact with the skin as the fluid from theincision is collected. However, the pressure exerted by the test stripagainst the skin can constrict the fluid flow from the incision suchthat the fluid sample size might be too small for accurate analysis.Other systems retract the test strip from the skin, but this is prone tocreating positional errors such that the capillary channel opening canbe located too far away from the skin to collect fluid. In either case,safe disposal of the integrated device is always a concern. Since thelancet is moveable, it can sometimes extend from the test strip afterlancing, thereby creating a potential cutting hazard. Springs or otherbiasing mechanisms can be used to bias the lancet inside the device inan unexposed position, but occasionally, the integrated device can becompressed or jarred so that the lancet is exposed to create a puncturehazard after use.

Thus, needs remain for further contributions in this area of technology.

SUMMARY

One aspect of the present invention concerns an integrated lancing teststrip device. The integrated lancing test strip device includes a lancetconfigured to form an incision in tissue and a test strip coupled to thelancet for analyzing body fluid. A retention mechanism acts as a detentto hold the lancet in a static position relative to the test stripbefore forming the incision. The retention mechanism is configured torelease the lancet for retracting the lancet relative to the test stripto reduce smearing of body fluid by the lancet during collection of thefluid with the test strip.

Another aspect concerns a unique method for collecting body fluid. Withthe method, a lancet is held in a fixed position relative to a teststrip in an integrated lancing test strip device. An incision is formedin tissue with at least a portion of the lancet extending from the teststrip. The lancet is released from the fixed position, and the lancet isretracted inside the integrated lancing test strip device after theincision is formed. Body fluid from the incision is collected with thetest strip after the lancet is retracted.

A further aspect concerns an integrated lancing test strip device thatincludes means for creating an incision in tissue and means foranalyzing body fluid from the incision. The device further includesmeans for holding the means for creating the incision in relation to themeans for analyzing the body fluid and for releasing the means forcreating the incision upon application of force.

Still yet another aspect concerns an apparatus that includes anintegrated lancing test strip device. The integrated lancing test stripdevice includes a test strip for analyzing body fluid. The test striphas a capillary channel with an opening for drawing the body fluid viacapillary action. The test strip is flat. A lancet is directly coupledto the test strip for forming an incision in tissue. An actuation deviceis coupled to the integrated lancing test strip device. The actuationdevice is configured to fire the lancet into the tissue. The actuationdevice is configured to rotate the lancet away from the incision inorder to minimize interference by the lancet as the body fluid from theincision is drawn into the capillary channel of the test strip.

Further forms, objects, features, aspects, benefits, advantages, andembodiments of the present invention will become apparent from adetailed description and drawings provided herewith.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a top view of an integrated lancing test strip deviceaccording to one embodiment.

FIG. 2 is a bottom view of the FIG. 1 integrated device with a lancetlocated in a static position.

FIG. 3 is a bottom view of the FIG. 1 integrated device with the lancetin a retracted position.

FIG. 4 shows the FIG. 1 integrated device lancing skin to form anincision.

FIG. 5 shows the FIG. 1 integrated device collecting fluid from theincision.

FIG. 6 is a side view of an actuation device for firing the FIG. 1integrated device.

FIG. 7 is a side view of the FIG. 6 device during lancing.

FIG. 8 is a side view of the FIG. 6 device as the lancet is retracted.

FIG. 9 is a side view of the FIG. 6 device as the FIG. 1 device is wipedacross the incision during sampling.

FIG. 10 is a top view of an integrated lancing test strip deviceaccording to another embodiment.

FIG. 11 is a bottom view of the FIG. 10 integrated device.

FIG. 12 shows the FIG. 10 device lancing the skin to form an incision.

FIG. 13 shows the FIG. 10 device as the lancet is retracted from theincision.

FIG. 14 shows the FIG. 10 device with the lancet in a fully retractedposition for collecting fluid from the incision.

FIG. 15 is a top view of an integrated lancing test strip deviceaccording to a further embodiment.

FIG. 16 shows the FIG. 15 device lancing the skin to form an incision.

FIG. 17 shows the FIG. 15 device as the lancet is retracted from theincision.

FIG. 18 shows the FIG. 15 device positioned to sample body fluid fromthe incision.

DESCRIPTION OF THE SELECTED EMBODIMENTS

For the purposes of promoting an understanding of the principles of theinvention, reference will now be made to the embodiments illustrated inthe drawings and specific language will be used to describe the same. Itwill nevertheless be understood that no limitation of the scope of theinvention is thereby intended, such alterations and furthermodifications in the illustrated device, and such further applicationsof the principles of the invention as illustrated therein beingcontemplated as would normally occur to one skilled in the art to whichthe invention relates. One embodiment of the invention is shown in greatdetail, although it will be apparent to those skilled in the relevantart that some features that are not relevant to the present inventionmay not be shown for the sake of clarity.

An integrated lancing test strip or disposable according to one of manyembodiments of the present invention includes a test strip and a lancet.The lancet is attached to the test strip so as to be initially in astatic (immobilized) position relative to the rest of the test strip,but is able to move inside the device after lancing the skin. In oneembodiment, breakable tabs are used to hold the lancet in place, and inanother embodiment, protrusions in the device act like detents to engageand hold the lancet in place. This ability to have the lancet fixed inposition before lancing, gives the device the ability to useconventional protective caps that maintain the sterility of the lancet.With the lancet fixed in position, the protective cap can be easilypulled or twisted off the lancet, either manually or automatically. Oncethe cap is removed, the integrated disposable, acting as a lancingmember, is fired by a lancing mechanism, thereby creating an incisionfrom which body fluid is sampled. After the incision is created, thelancet is retracted (mobilized) inside the device such that the lancetmoves away from the incision, thereby giving a clear path for thecapillary channel of the test strip to contact and collect the bodyfluid. With the clear path, body fluid can then be easily drawn into thecapillary channel of the test strip without having the lancet interferewith the sample collection. In one form, the lancet is retracted in alinear fashion, and in another form, the lancet is rotated duringretraction. The lancing device, which houses the integrated lancing teststrip, includes a firing mechanism for firing the integrated device, astabilizer bar, a lancet stabilizer arm, and a deflection arm. Thedeflection arm enhances sample contact by flexing the integrateddisposable in a sweeping motion toward the sample droplet. In stillanother embodiment, the lancet remains fixed after lancing, but theentire integrated lancing test strip is rotated so that a capillarychannel, which is offset from the lancet, is rotated into position overthe incision.

FIGS. 1, 2, and 3 illustrate an integrated lancing test strip device ordisposable 30 according to one embodiment of the present invention. Asshown in FIG. 1, the integrated device 30 includes a test strip 32 thatis coupled to a lancet 34. In the illustrated embodiment, the test strip32 is an electrochemical type test strip, but it should be recognizedthat other types of test strips can be used, such as for examplecolorimetric or optical type test strips, to name a few. The test strip32 includes a connector portion 36 with electrical contacts that connectthe integrated device 30 to a sampling device or meter such that theintegrated device 30 is able to transfer the test results to the meter.The test strip 32 further includes an analysis portion or area 38 inwhich the fluid sample is analyzed. In one form, the analysis portion 38includes a reagent and electrodes, such as working, counter andreference electrodes, for analyzing the fluid sample. The test strip 32includes a capillary channel 40 with a capillary channel opening 41 fortransporting body fluid to the analysis portion 38. The analysis portion38 is located in one end of the capillary channel 40, opposite thecapillary channel opening 41. The capillary channel 40 is sized andconfigured to draw body fluid via capillary action from the channelopening 41 onto the analysis portion 38. The capillary channel 40 asshown is Y-shaped, but it is contemplated that the channel 40 can beshaped differently in other embodiments. To assist in drawing fluid, thecapillary channel 40 can include a vent opening or slot. Furthermore,the integrated lancing test strip 30 in the illustrated embodiment has agenerally flat profile. By being flat, the integrated device 30 can beformed by sandwiching sheets of the various components together to formindividual integrated devices 30. The flat shape also allows multipleintegrated devices 30 to be combined together into, for example,cassettes, cartridges, magazines, drums and the like so as to allowmultiple tests without the need to reload the meter with additionalintegrated devices 30. As should be recognized, the integrated devices30 can also be loaded and used in a meter on an individual basis. In oneparticular form, the test strip 32 includes an ACCU-CHEK® brand teststrip (Roche Diagnostics GmbH), but it is envisioned that other types oftest strips can be used. Moreover, it is contemplated that theintegrated device 30 can have a different overall shape in otherembodiments. By way of a non-limiting example, the integrated device 30in other embodiments can have an overall rounded shape.

With continued reference to FIG. 1, the lancet 34 is encapsulated in aprotective cover 42 so as to maintain the sterility of the lancet 34. Inone form, the cover 42 is a plastic cap that can be pulled or twistedoff the lancet 34 before use. The cover 42 can be manually removed bythe user and/or automatically removed by the meter. It is contemplatedthat the protective cover 42 can come in other forms. For example, theprotective cover 42 in another embodiment includes two sheets of filmthat are peeled from the lancet 34 prior to use. Looking at FIG. 2, theintegrated device 30 includes a lancet guide channel 44 in which thelancet 34 is disposed. In one form, a sheet or a layer of materialcovers the lancet channel 44 so as to keep the lancet 34 inside thelancet channel 44. The lancet channel 44 extends longitudinally alongthe integrated device 30 so that the lancet is retracted in a linearmanner. As will be appreciated, the lancet channel 44 can be shapeddifferently in other embodiment so that the lancet 34 can be retractedin other manners. The lancet channel 44 in one embodiment is formeddirectly in the test strip 32, and in another embodiment, the channel 44is defined by a separate spacer member that is attached to the teststrip 32. As should be appreciated, the lancet channel 44 can be definedin other ways. In the illustrated embodiment, the lancet 34 is generallyflat, but in other embodiments, the lancet 34 can be rounded or have adifferent overall shape. In the illustrated embodiment, the lancetchannel 44 in which the lancet 34 is received and the opening 41 of thecapillary channel 40 are longitudinally aligned with one another onopposite sides of the test strip 32 so that the capillary channelopening 41 is positioned close to the incision formed by the lancet 34so as to promote fluid collection. As will be appreciated from thedescription of the other embodiments, the lancet 34 and the capillarychannel opening 41 can be offset from one another in other embodiments.

Inside the lancet channel 44, the device 30 has a retention mechanism orstructure 45 that acts like a detent mechanism to hold the lancet 34 inplace relative to the test strip 32 before lancing, and allows thelancet 34 to be retracted inside the lancet channel 44 after lancing.With the retention structure 45, the protective cover 42 can be easilyremoved from the lancet 34 without damaging the integrated lancing teststrip 30. For instance, if the integrated device 30 did not have theretention mechanism 45, the lancet 34 could be completely removed fromthe lancet channel 44 by the pulling and/or twisting action as the cover42 is removed. In the depicted embodiment, the retention mechanism 45 isconfigured to retain the lancet 34, by friction, within the lancetchannel 44 after lancing, as is shown in FIG. 3. This in turn eliminatesthe need for the cover 42 or some other protective structure from beingplaced over the lancet 34 after use, and further, reduces the chances ofinjuries during disposal. Some typical integrated lancing test stripdesigns with moveable lancets require a spring to retract and bias thelancet within the test strip so that the lancet is covered duringdisposal. However, springs can be expensive, especially for high volumeitems like disposable integrated lancing test strips, and further,springs are not always strong enough to retain the lancet within thetest strip so as to prevent accidental cuts. As should be recognized,the retention mechanism 45 eliminates the need for springs in theintegrated device so that the above-mentioned difficulties are reducedor even eliminated. Although not required, it is contemplated that inother embodiments springs can be used in conjunction with the retentionmechanism 45 to retain the lancet 34 within the lancet channel 44.

In the embodiment illustrated in FIGS. 2 and 3, the retention mechanism45 includes one or more breakable tabs 46 that secure the lancet 34 tothe walls of the lancet channel 44. As shown, two breakable tabs 46connect two opposing sides of the lancet 34 to the test strip 32. Thetabs 46 in this embodiment prevent longitudinal movement as well asrotational movement of the lancet 34. After forming an incision, thetabs 46 also serve to retain the lancet 34 inside the integrated device30 by frictionally engaging the lancet 34. The tabs 46 are constructedto break when a specified force is applied to retract the lancet 34. Inone form, the breakable tabs 46 are made of fracturable plastic materialthat is strong enough to hold the lancet 34 in place during lancing, butis able to break to allow retraction of the lancet 34. It, however,should be appreciated that the tabs 46 can be made of other materials.Moreover, it is envisioned that the retention mechanism 45 can includeothers types of mechanisms and/or structures for holding the lancet 34in relation to the test strip 32 so that the lancet 34 can be releasedby an applied force. For example, the retention mechanism 45 can includean adhesive that is applied between the lancet 34 and the test strip 32.The adhesive holds the lancet 34 in place during lancing, but releasesthe lancet 34 when a predefined (or greater) force is applied betweenthe lancet 34 and the test strip 32 during retraction. In anotherembodiment, a ball and spring type detent mechanism is used to hold thelancet 34 in place. It is contemplated that in other embodiments theretention mechanism 45 can be configured to release and make the lancet34 moveable, once the protective cover 42 is removed from the lancet 34.

The lancet 34 has an engagement hole or opening 48 defined in body 50 ofthe lancet 34 that is used to engage the lancet 34. Although theengagement hole 48 in the embodiment shown is circular, the engagementhole 48 can be shaped differently in other embodiments and/or includeother types of structures for coupling to the lancet 34 to a lancingdevice. In FIGS. 2 and 3, a lancet tip or blade 52 for puncturing theskin or other tissue extends from the lancet body 50. In the embodimentshown, the lancet body 50 is wider than the lancet tip 52. At theinterface between the lancet body 50 and the tip 52, the lancet 34 has adepth penetration edge 53 that limits the penetration of the lancet 34into the skin or other tissue.

Before lancing, the retention mechanism 45 in one embodiment holds thelancet 34 with the lancet tip 52 extending from the test strip 32, as isillustrated in FIGS. 1 and 2. With this construction, the entireintegrated device 30 is fired against the skin, and the tabs 46 arebroken as the lancet 34 is retracted inside the lancet channel 44 Asdepicted in FIG. 4, during lancing, the lock tabs 46 hold the lancet 34fixed in place such that the lancet tip 50 extends from the test strip32 as the skin is lanced. The penetration edges 53 on the lancet 34limit the penetration depth of the lancet tip 52 into skin or tissue 54.The penetration edges 53 also provide a reference surface for verticallyspacing the edge of the test strip 32 away from the skin 54, which inturn promotes bleeding from the incision 56. As noted before, contactbetween the test strip 32 and the skin 54 can create pressure thatconstricts fluid flow to the incision. By spacing the test strip 32 fromthe skin 54 in such a manner, the chance of fluid flow constriction isreduced. At the same time, it is ensured that the test strip 32 is notspaced too far away from the skin 54 so as to be unable to collect asufficient sample of body fluid 58, such as blood, interstitial fluidand other fluids.

Before lancing the skin 54, the skin 54 can be stimulated to enhancefluid flow, if so desired. After an incision 56 in the skin 54 isformed, the lancet 34 is retracted into the lancet channel 44 of thedevice 30, as shown in FIG. 5. During retraction, the lancet 34 moves,but the test strip 32 remains vertically stationary relative to the skin54 so that the spacing between the test strip 32 and the skin 54 ismaintained. With the lancet 34 located inside the integrated device 30,the lancet 34 does not interfere with fluid collection. After formingthe incision 56, body fluid 58 can be expressed from the incision 56either manually or automatically in the manners as known to thoseskilled in the art. As the body fluid 58 bleeds from the incision 56,the fluid 58 is then drawn into the capillary channel 40 via capillaryaction. As should be recognized, portions of the integrated lancing teststrip 30 can be hydrophobic and/or hydrophilic so as to direct fluidflow. The fluid 58 is then drawn to the analysis area 38, where thefluid 58 is analyzed, and the results of the analysis are sent to themeter via the connector portion 36. After retraction of the lancet 34,the tabs 46 help to retain the tip 52 of the lancet 34 within thechannel 44 such that the integrated device 30 can be disposed of withminimal risk of accidental puncturing of the skin. By having theposition of the lancet 34 fixed relative to the test strip 32 duringlancing and allowing the lancet 34 afterwards to retract independentlyof the test strip 32, the spacing of the test strip 32 from the skin 54can be accurately set and maintained, thereby promoting collection ofthe body fluid 58 from the incision 56.

In another embodiment, before lancing, the retention mechanism 45immobilizes the lancet 34 with the lancet tip 52 positioned inside theintegrated device 30, in the manner as shown in FIG. 3. By having thelancet tip 52 positioned inside the integrated device 30 before use, therisk of accidental injury from the lancet 34 is reduced. The opening ofthe lancet channel 44 can be sealed to maintain sterility and/or theintegrated device 30 can be packaged in other manners to maintainsterility. In this embodiment, the tabs 46 are broken during lancing sothat the lancet 34 moves relative to the test strip 32 during bothextension and retraction. After lancing, the frictional engagementbetween the breakable tabs 46 and the lancet 34 help to retain thelancet 34 within the integrated device 30.

FIG. 6 illustrates an actuating device (or meter) 60 that is used tofire and retract the integrated lancing test strip device 30 illustratedin FIG. 1. It should be recognized, however, that the device 60 can beused to actuate other types of integrated lancing test strips, such asfor the other embodiments described herein. As shown, device 60 includesa lancing mechanism 62 that is used to fire the lancet 34, and aconnector 64 that connects the integrated device 30 to the lancingmechanism 62. In one form, the lancing mechanism 62 includes a motor,such as an electric or pneumatic type motor, and in another form, thelancing mechanism 62 is a spring driven type of device. It should beappreciated that the lancing mechanism 62 can include other types offunctionally similar devices as would occur to those skilled in the art.The connector 64 engages the strip connector 36 such that the testresults can be transferred to a signal converter or meter that is usedto process the results. Device 60 further includes a lancetstabilizer/retractor arm 66 with an engagement member or pin 68 that isconstructed to engage the engagement hole 48 in the lancet 34. Inconjunction with the lancing mechanism 62, the retractor arm 66 isconfigured to retract the lancet 34 into the integrated device 30. Thedevice 60 further incorporates a deflection mechanism 70 that is used todeflect the test strip 32 so that the capillary channel 40 in the teststrip 32 is deflected over the incision 56 to collect body fluid 58.

As depicted, the deflection mechanism 70 includes a deflection arm 72and a strip stabilizer 74. The deflection arm 72 and the stripstabilizers 74 each include opposing cam surfaces 76, 78 that engage oneanother to bend the strip stabilizer 74. The strip stabilizer 74 furtherincludes an engagement portion or pillow button (block) 80 that engagesthe integrated lancing test strip 30. To deflect the test strip 32, thedeflection arm 72 is extended by the lancing mechanism 62. As thedeflection arm 72 is extended, the cam surface 76 on the deflection arm72 pushes against the cam surface 78 on the strip stabilizer 74. Thisaction bends the strip stabilizer 74 such that the pillow button 80pushes against the test strip 32. As a result, the test strip 32 bendsso that the opening 41 of the capillary channel 40 wipes across theincision 56.

FIGS. 7, 8 and 9 illustrate the operation and configuration of theactuation device 60 during the lancing, retracting and sampling stages,respectively. As illustrated in FIG. 7, the connector 64 along with theretractor arm 66 is fired in unison by the lancing mechanism 62 so thatthe integrated device 30 is fired against the skin 54. As can be seen inFIG. 8, the lancet 34 forms an incision 56 in the skin 54, and afterforming the incision 56, the retractor arm 66 retracts the lancet 34away from the skin 54, while the connector 64 remains fixed in position.Consequently, the tabs 46 in the lancet channel 44 are broken so thatthe lancet 34 is able to move relative to the test strip 32, and thelancet 34 is retracted inside the integrated device 30. A droplet ofbody fluid 58 from the incision 56 forms on the skin 54. To collect thefluid 58, the deflection mechanisms 70 sweeps the test strip 32 over thedroplet of fluid 58. It should be noted that by retracting the lancet 34into the integrated device 30 the overall flexibility of the test strip32 can increase such that the test strip 32 can be easily bent.Referring to FIG. 9, the lancing mechanism 62 extends the deflection arm72 towards the skin 54. When the deflection arm 72 extends, the camsurface 76 on the deflection arm 72 pushes against the cam surface 78 onthe strip stabilizer 74. This action bends the strip stabilizer 74 suchthat the pillow button 80 pushes against the test strip 32.Consequently, the test strip 32 bends so that the opening 41 of thecapillary channel 40 wipes across the incision 56. The swiping action ofthe test strip 32 over the incision 56 can occur only once or can berepeated a number of times. The fluid 58 drawn into the capillarychannel 40 is analyzed in the manner as described above, and the resultsfrom the analysis are sent to the meter through the connector 64.

An integrated lancing test strip device 84 according to anotherembodiment is illustrated in FIGS. 10 and 11. As can be seen, theintegrated device 84 in FIG. 10 shares a number of features in commonwith the previously described embodiment. For the sake of clarity aswell as brevity, these common features will not be described in greatdetail again, but rather reference is made to the previous discussion ofthese features. The integrated device 84 includes the test strip 32,like the one described above, with the connector 36 for connecting to ameter. Like before, the test strip 32 has the capillary channel 40 withthe capillary opening 41 and the analysis portion 38 for testing thebody fluid sample.

On the side opposite the capillary channel 40, the integrated device 84in FIG. 11 has a lancet 86 that is pivotally coupled to the test strip32. Instead of retracting the lancet 86 in a longitudinal or linearfashion, the lancet 86 in the illustrated embodiment is retracted in arotational manner. In particular, the lancet 86 is pivotally coupled tothe test strip 32 via a pivot pin 88. The lancet 86 as well as the pivotpin 88 is positioned within a lancet channel 90 that has a generallycircular shape to permit rotation of the lancet 86, while minimizing thesize of the lancet channel 90. Again, it should be recognized that thelancet channel 90 can be shaped differently in other embodiments. Thelancet 86 includes a lancet body 50 from which a lancet tip 52 extendsfor forming an incision in skin. The lancet body 50 is wider than thelancet tip 52 so as to form penetration edge 53, which acts to controlthe penetration depth of the lancet 86 and vertically position thecapillary opening 40 relative to the skin. The lancet body 50 definesone or more pivot openings 92, which are located radially outward fromthe pivot pin 88 in order to permit the application of torque to rotatethe lancet 86. The lancet 86 in the illustrated embodiment has two pivotopenings 92 located on opposite sides of the pivot pin 88. Nevertheless,it should be understood that the lancet 86 can have more or less pivotopenings 92 than is shown, and the pivot openings 92 can be shapeddifferently. As should be further recognized, the lancet 86 can bemodified to be rotated by other types of mechanisms.

The integrated device 84 in FIG. 11 has a retention mechanism orstructure 93 acts like a detent mechanism to fix the orientation of thelancet 86 relative to the test strip 32. In the FIG. 11 embodiment, theretention mechanism 93 includes one or more retention pins or dimples94. The lancet 86 is held rotationally fixed or immovable relative tothe test strip 32 by two retention pins 94 positioned on opposing sidesof the lancet 86, when the lancet 86 is in an extended position. In oneform, the pins 94 are in the form of plastic protrusions extendingwithin the lancet channel 90, but it should be understood that the pins94 can be formed from other materials. The pins 94 can be also orientedin other manners than is shown. Further, it is envisioned that othertypes of retention mechanisms or structures 93 can be used. In theillustrated embodiment, the lancet tip 52 is covered by protective cover42 to maintain the sterility of the lancet 86 and prevent accidentalpunctures. As mentioned before, by having the lancet 86 in an immovablestate, the protective cap 42 can be easily removed prior to use. Inanother embodiment, the lancet 86 prior to use is oriented such that thelancet tip 52 is positioned within the lancet channel 90, as is shown inFIG. 14. With the lancet tip 52 inside the lancet channel 90, the riskof accidental injury is reduced. To maintain the sterility of the lancet86, the opening of the lancet channel 90 can be sealed and/or the entireintegrated device 84 can be packaged in a sterile enclosure.

FIGS. 12, 13 and 14 illustrate the various stages of sampling fluid froman incision with the integrated lancing test strip 84. Looking at FIG.12, the entire integrated device 84 is fired against the skin 54 withthe lancet 86 in an immovable position in which the lancet tip 52extends from the test strip 32. The retention pins 94 retain the lancet86 in the fixed position relative to the test strip 32. After formingthe incision 56 in the skin 54, the lancet 86 is retracted via arotational motion, as is depicted in FIGS. 13 and 14. Before rotatingthe lancet 86, the integrated device 84 in one embodiment is pulled awayslightly from the skin 54 so that the lancet tip 52 is removed from theincision 56. In another embodiment, the lancet 86 is rotated while stillin the incision 56 such that the incision 56 is enlarged. By enlargingthe incision 56, a greater amount of body fluid 58 can bleed from theincision 56 at a given penetration depth. Automatic or manual expressionof fluid 58 from the incision 56 can occur, if needed, after theincision 56 is formed.

To rotate the lancet 86, the opposing pin openings 92 in one embodimentare engaged by a modified version of the stabilizer/retractor arm 66(FIG. 6), which includes two engagement pins 68 for engaging the pinopenings 92. The modified retractor arm 66 in this embodiment includesan electric motor to rotate the engagement pins 68. However, in otherembodiments, other mechanisms that perform a similar function, such aspneumatic motors, linkages, pulleys and the like, can be used. Moreover,it is contemplated that the lancet 86 can be rotated in other manners.As pressure is applied when rotation is initiated, the retention pins 94give way to allow rotation of the lancet 86. As can be seen in FIG. 14,the lancet 86 continues to rotate until one side of the lancet 86 engageboth retention pins 94 so that the lancet tip 52 is positioned insidethe integrated device 84. If so desired, the lancet 86 can be furtherrotated and locked in position such that the lancet tip 52 extends awayfrom the incision 56. With the retention pins 94 engaging to one side ofthe lancet 86, the lancet 86 is unable to protrude from the test strip32, unless an outside force is applied. As such, the droplets of bodyfluid 58 can be drawn into the capillary channel 40 of the test strip 32without the lancet 86 interfering with fluid collection. In one form,the modified version of the actuation device 60 in FIG. 6 can be used tobend the test strip 32 to swipe the test strip across the incision 54.In another embodiment, the test strip 84 can collect fluid without theflexing or swiping motion. It also is envisioned that portions of theintegrated device 84 can be made, treated and/or configured to behydrophobic or hydrophilic so as to direct the flow of the body fluid58. For instance, the lancet channel 90 in one form is coated with ahydrophobic coating so that the body fluid 58 is directed away from thelancet channel 90.

An integrated lancing test strip device 100, according to anotherembodiment, that uses a rotational motion to collect fluid will now bedescribed with reference to FIGS. 15, 16, 17 and 18. As can be seen inFIG. 15, the integrated device 100 shares a number features in commonwith the previously described embodiments. Once more, for the sake ofclarity as well as brevity, these common features will not be againdescribed in great detail below, but reference is made to the previousdescription of these features.

As mentioned before, some previous integrated disposable designs wereproposed in which a lancet is fixed to a body that holds a separatesensor, which is then rotated into position to collect body fluid.However, the body for such type of disposable was typically made from anextruded plastic that made them rather bulky and expensive tomanufacture. Due to their bulky nature, these types of disposables weredifficult to incorporate into magazines, drums, cassettes or cartridges.In contrast, the shape of the integrated lancing test strip 100 in theFIG. 15 embodiment is generally flat and compact, which makes theintegrated lancing test strip 100 ideal for magazines, drums, cassettes,cartridges and the like. Manufacturing of the FIG. 15 integrated lancingtest strip 100 is also simpler as compared to the prior disposabledesigns. For example, the integrated lancing test strip 100 in oneembodiment is formed by layering and adhering a series of materialstrips or sheets, which is ideal for a continuous manufacturing process.The integrated lancing test strip 100 also eliminates the need for aseparate body.

As shown, the integrated device 100 includes a test strip 102 withconnector portion 36 and a lancet 104 that is coupled the test strip102. In the illustrated embodiment, the lancet 104 is fixed to the teststrip 102. However, the lancet 104 in other embodiments is coupled tothe test strip 102 in a moveable manner, such as in the embodimentspreviously described. For example, the lancet 104 can be coupled to thetest strip 102 through a detent mechanism that allows the lancet 104 toretract inside the integrated device 100 such that the lancet 104 doesnot interfere with fluid collection. In the FIG. 15 embodiment, the teststrip 102 is an electrochemical type test strip, but it should beappreciated that other types of test strips can be used, such as acolorimetric type test strip. As can be seen, the lancet 104 ispositioned offset from the central longitudinal axis 106 of theintegrated device 100 such that the lancet 104 extends along one side ofthe test strip 102, parallel to the longitudinal axis 106. To provide acompact profile, the lancet 104 in the depicted embodiment is generallyflat, and the lancet 104 includes a lancet tip 52 for forming anincision in tissue and a body portion 50 that connects the lancet tip 52to the rest of the lancet 104.

Referring to FIG. 15, the test strip 102 defines a capillary channel 108that has an analysis portion 38 for analyzing the fluid sample. Thecapillary channel 108 has an opening 110 that is offset from thelongitudinal axis 106 of the test strip 102 and slanted at an angle 112relative to the longitudinal axis 106. In one form, the angle 112between the capillary opening 110 and the longitudinal axis 106 is anoblique angle. As shown, the capillary channel 108 has a boomerangshape, and the capillary channel opening 110 is Y-shaped with a curvedopening. However, it is envisioned that the channel 108 can be shapeddifferently in other embodiments. The illustrated test strip 102 has agenerally rectangular shape, with the exception that the test strip 102has a truncated corner 114 at the capillary channel opening 110. Thetruncated corner 114 allows the capillary channel opening 110 to berotated over the incision site without having the test strip 102contacting the skin or the body fluid drop, which could potentiallysmear the drop of fluid.

By having the ability to rotate the lancet 104 out of the way, thecapillary channel 108 is able to collect the fluid sample without thelancet 104 interfering with the sample collection. In some embodiments,the integrated device 100 is rotated between 30° to 180° to collect thefluid sample. To minimize the rotation of the test strip 102, the lancet104 and the capillary channel 108 are located near the same end of thetest strip 102. It is nonetheless contemplated that the lancet 104 andthe capillary channel 108 can be positioned differently for otherembodiments. For example, the orientation of the lancet 104 and thecapillary channel 108 can be reversed such that the capillary channel108 extends parallel to the longitudinal axis 106 and the lancet 104extends in a nonparallel manner relative to the longitudinal axis 106.The integrated lancing test strip 100 in one form is rotated manually bythe user after the incision is formed, and in another form, the meterautomatically rotates the integrated lancing test strip 100. Toautomatically rotate the integrated device 100, the integrated device100 includes a coupling structure 114 that allows a modified version ofthe FIG. 6 actuating device 60, or some other type of meter, to rotatethe integrated device. In the illustrated embodiment, the test strip 102has one or more engagement holes 116 through which the test strip 102 isheld and rotated. It is envisioned that other types of couplingstructures with different configurations can be used to rotate theintegrated device 100.

Referring now to FIGS. 16, 17 and 18, there is illustrated the variousstages for collecting and analyzing a body fluid sample with theintegrated device 100. As shown in FIG. 16, the lancet 104 lances theskin 54 by having the entire integrated lancing device 100 fired towardsthe skin 54. After rupturing the skin 54, the entire integrated device100 is then retracted from the skin 54 so as to promote fluid flow fromthe incision 56, as is illustrated in FIG. 17. If needed, after theincision 56 is formed, body fluid 58 can be manually or automaticallyexpressed by stimulating the skin 54 surrounding the incision 56. Once asufficient amount of fluid 58 collects on the skin 54, the entireintegrated device 100 is rotated so that the capillary channel 108 isable to collect body fluid 58 from the incision 56, as is depicted inFIG. 18. The test strip 102 is rotated such the lancet 104 moves awaygiving a clear path for the capillary 108 of the test strip 102 tocontact the body fluid 58. In the embodiment where the lancet 104 is notfixed to the test strip 102, the lancet 104 can be retracted inside theintegrated device 100 so as to further reduce the chance of the lancet104 interfering with fluid collection and the risk of accidentallystabbing with the lancet 104. As mentioned before, the integrated device100 can be rotated manually by the user, for example by repositioningthe entire meter, or the entire integrated lancing device 100 can berotated automatically by the meter. The body fluid 58 is then drawn bythe capillary channel 108 into the analysis area 38 where the sample isanalyzed. In the illustrated embodiment, the integrated device 100 isconnected to a signal converter or meter through the strip connector 36,and the results from the analysis are transferred to the meter throughthe connector 36.

While the invention has been illustrated and described in detail in thedrawings and foregoing description, the same is to be considered asillustrative and not restrictive in character. It should be understoodthat only the preferred embodiment has been shown and described and thatall changes and modifications that come within the spirit of theinvention are desired to be protected. All publications, patents, andpatent applications cited in this specification are herein incorporatedby reference as if each individual publication, patent, or patentapplication were specifically and individually indicated to beincorporated by reference and set forth in its entirety herein.

1. An apparatus, comprising: an integrated lancing test strip deviceincluding a lancet configured to form an incision in tissue, a teststrip coupled to the lancet for analyzing body fluid from the incision,and a retention mechanism that holds the lancet in a static positionrelative to the test strip before formation of the incision, wherein theretention mechanism is configured to release the lancet for retractingthe lancet relative to the test strip in order to reduce interference bythe lancet during collection of the body fluid with the test strip. 2.The apparatus of claim 1, further comprising a protective cover coveringat least a portion of the lancet, wherein the retention mechanism holdsthe lancet during removal of the protective cover.
 3. The apparatus ofclaim 1, wherein the retention mechanism includes one or more breakabletabs coupled between the lancet and the test strip, wherein thebreakable tabs are configured to break when a predefined force isapplied to permit retraction of the lancet.
 4. The apparatus of claim 1,wherein the retention mechanism includes one or more retention dimplesthat engage the lancet, wherein the dimples are configured to releasethe lancet when a predefined force is applied to permit retraction ofthe lancet.
 5. The apparatus of claim 1, wherein the lancet isconfigured to retract in a translational fashion relative to the teststrip.
 6. The apparatus of claim 1, wherein the lancet is rotatablycoupled to the test strip for retracting in a rotational fashionrelative to the test strip.
 7. The apparatus of claim 1, wherein thelancet defines one or more engagement openings for transmitting forceduring retraction.
 8. The apparatus of claim 1, wherein when in thefixed position at least a portion of the lancet extends from the teststrip.
 9. The apparatus of claim 1, wherein: when in the fixed positionthe lancet is positioned in a retracted position inside the integratedlancing test strip to reduce risk of injury; and the retention mechanismreleases the lancet to allow at least a portion of the lancet to extendfrom the test strip during formation of the incision.
 10. The apparatusof claim 1, wherein the retention mechanism is configured to hold thelancet in a retracted position after formation of the incision to reducerisk of injury during disposal of the integrated lancing test stripdevice.
 11. The apparatus of claim 1, further comprising: an actuationmechanism coupled to the integrated lancing test strip, wherein theactuation mechanism includes a deflection mechanism configured to swipethe test strip over the body fluid from the incision.
 12. The apparatusof claim 11, wherein the actuation mechanism includes a retractionmechanism configured to apply force to release the lancet from theretention mechanism and retract the lancet.
 13. A method, comprising:holding a lancet in a fixed position relative to a test strip of anintegrated lancing test strip device; forming an incision in tissue withat least a portion of the lancet extending from the test strip;releasing the lancet from the fixed position; retracting the lancetafter said forming the incision; and collecting body fluid from theincision with the test strip after said retracting the lancet.
 14. Themethod of claim 13, wherein said releasing the lancet occurs after saidforming the incision.
 15. The method of claim 13, wherein: said holdingthe lancet in the fixed position includes having the lancet in aretracted position; said releasing the lancet occurs before said formingthe incision; and said forming the incision includes extending at leasta portion of the lancet from the test strip.
 16. The method of claim 13,wherein said retracting includes rotating the lancet relative to thetest strip.
 17. The method of claim 13, wherein said retracting includestranslational moving of the lancet relative to the test strip.
 18. Anintegrated lancing test strip device, comprising: means for creating anincision in tissue; means for analyzing body fluid from the incision;and means for holding said means for creating the incision in relationto said means for analyzing the body fluid and for releasing said meansfor creating the incision upon application of force.
 19. The device ofclaim 18, wherein: said means for creating the incision includes alancet; said means for analyzing the body fluid includes a test strip;and said means for holding includes a detent mechanism.
 20. Anapparatus, comprising: an integrated lancing test strip device includinga test strip for analyzing body fluid, the test strip having a capillarychannel with an opening for drawing the body fluid via capillary action,wherein the test strip is flat, and a lancet directly coupled to thetest strip for forming an incision in tissue; and an actuation devicecoupled to the integrated lancing test strip device, the actuationdevice being configured to fire the lancet into the tissue, wherein theactuation device is configured to rotate the lancet away from theincision in order to minimize interference by the lancet as the bodyfluid from the incision is drawn into the capillary channel of the teststrip.
 21. The apparatus of claim 20, wherein: the lancet is pivotallycoupled to the test strip; and the actuation device is configured torotate the lancet relative to the test strip.
 22. The apparatus of claim20, wherein: the lancet is fixed to the test strip; the capillarychannel is angled in a nonparallel manner relative to the lancet; theactuation device is configured to rotate the lancet away from theincision by rotating the entire integrated lancing test strip device;and the test strip has a truncated corner at the opening of thecapillary channel to reduce smearing of the body fluid as the integratedlancing test strip device is rotated.